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By Coweta Dentistry Associates
December 10, 2018
Category: Oral Health
Tags: osteoporosis  
ManageYourOsteoporosisMedicationtoAvoidJawboneProblems

Around 20 million people—mostly women after menopause—take medication to slow the progress of osteoporosis, a debilitating disease that weakens bones. But although effective, some osteoporosis drugs could pose dental issues related to the jawbones.

Osteoporosis causes the natural spaces that lie between the mineral content of bone to grow larger over time. This makes the bone weaker and unable to withstand forces it once could, which significantly increases the risk of fracture. A number of drugs have been developed over time that stop or slow this disease process.

Two of the most prominent osteoporosis drugs are alendronate, known also by its trade name Fosamax™, and denosumab or Prolia™. While originating from different drug families, alendronate and denosumab work in a similar way by destroying specialized bone cells called osteoclasts that break down worn out bone and help dissolve it. By reducing the number of these cells, more of the older bone that would have been phased out lasts longer.

In actuality this only offers a short-term benefit in controlling osteoporosis. The older bone isn’t renewed but only preserved, and will eventually become fragile and more prone to fracture. After several years the tide turns negatively for the bone’s overall health. It’s also possible, although rare, that the bone simply dies in a condition called osteonecrosis.

The jawbones are especially susceptible to osteonecrosis. Forces generated by chewing normally help stimulate jawbone growth, but the medications in question can inhibit that stimulus. As a result the jawbone can diminish and weaken, making eventual tooth loss a real possibility.

Osteonecrosis is most often triggered by trauma or invasive dental procedures like tooth extractions or oral surgery. For this reason if you’re taking either alendronate and denosumab and are about to undergo a dental procedure other than routine cleaning, filling or crown-work, you should speak to your physician about suspending your medication temporarily. Dentists often recommend a suspension of three to nine months before the procedure and three months afterward.

Some research indicates this won’t worsen your osteoporosis symptoms, especially if you substitute another treatment or fortify your skeletal system with calcium and vitamin D supplements. But taking this temporary measure could help protect your teeth in the long run.

If you would like more information on the effect of osteoporosis treatment on dental health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Osteoporosis Drugs & Dental Treatment.”

By Coweta Dentistry Associates
November 30, 2018
Category: Dental Procedures
Tags: crowns  
4SituationsWhereaCrownCouldImproveanExistingTooth

Porcelain crowns have been used to restore problem teeth since at least the early 20th Century. Crown technology has gradually progressed from the early use of precious metals like gold or silver to more life-like porcelain crowns, often with a metal interior for added strength. Today, most crowns are all-porcelain, made with newer materials that not only look attractive but can endure under the pressures of daily chewing or biting.

While crowns are often part of restorations for missing teeth, they’re also commonly used to cap or fit over a viable tooth with structural or appearance problems. Here are 4 situations where a crown could improve a tooth’s form and function.

Traumatized teeth. A significant blow to the face or mouth could generate enough force to chip away or fracture a significant amount of structure from a tooth. If the root remains healthy and firmly attached within the jaw, however, a crown can replace the missing structure and restore the tooth’s function and appearance.

Root canal treatments. Root canal treatments remove infected or dead tissue within a tooth’s pulp chamber, its inner core, and the root canals. The procedure rescues the tooth but can in the process significantly alter the tooth’s structure and appearance. A crown not only restores the tooth but also provides added protection against further decay or tooth fracture.

Teeth with multiple fillings. We can effectively treat cavities caused by tooth decay by filling them. But with each filling we must remove more of the decayed structure and shape the cavity to accommodate the filling. After a number of times, a tooth may not have enough structure left to support another filling. If the tooth is still viable, a crown could solve this dilemma.

Abnormally developed teeth. Teeth sometimes don’t erupt in the jaw as they should and may be only partly visible. The tooth not only looks out of place but it can’t fully function like a normal tooth. Capping an abnormally developed tooth with a crown will help normalize it and allow it to blend in with surrounding teeth.

If you would like more information on crown restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Crowns & Bridgework.”

By Coweta Dentistry Associates
November 20, 2018
Category: Dental Procedures
WhyemBigBangTheoryemActressMayimBialikCouldntHaveBraces

Mayim Bialik has spent a good part of her life in front of TV cameras: first as the child star of the hit comedy series Blossom, and more recently as Sheldon Cooper’s love interest — a nerdy neuroscientist — on The Big Bang Theory. (In between, she actually earned a PhD in neuroscience from UCLA…but that’s another story.) As a child, Bialik had a serious overbite — but with all her time on camera, braces were just not an option.

“I never had braces,” she recently told Dear Doctor – Dentistry & Oral Health magazine. “I was on TV at the time, and there weren’t a lot of creative solutions for kids who were on TV.” Instead, her orthodontist managed to straighten her teeth using retainers and headgear worn only at night.

Today, there are several virtually invisible options available to fix orthodontic issues — and you don’t have to be a child star to take advantage of them. In fact, both children and adults can benefit from these unobtrusive appliances.

Tooth colored braces are just like traditional metal braces, with one big difference: The brackets attached to teeth are made from a ceramic material that blends in with the natural color of teeth. All that’s visible is the thin archwire that runs horizontally across the teeth — and from a distance it’s hard to notice. Celebs like Tom Cruise and Faith Hill opted for this type of appliance.

Clear aligners are custom-made plastic trays that fit over the teeth. Each one, worn for about two weeks, moves the teeth just a bit; after several months, you’ll see a big change for the better in your smile. Best of all, clear aligners are virtually impossible to notice while you’re wearing them — which you’ll need to do for 22 hours each day. But you can remove them to eat, or for special occasions. Zac Efron and Katherine Heigl, among others, chose to wear clear aligners.

Lingual braces really are invisible. That’s because they go behind your teeth (on the tongue side), where they can’t be seen; otherwise they are similar to traditional metal braces. Lingual braces are placed on teeth differently, and wearing them often takes some getting used to at first. But those trade-offs are worth it for plenty of people. Which celebs wore lingual braces? Rumor has it that the list includes some top models, a well-known pop singer, and at least one British royal.

So what’s the best way to straighten your teeth and keep the orthodontic appliances unnoticeable? Just ask us! We’d be happy to help you choose the option that’s just right for you. You’ll get an individualized evaluation, a solution that fits your lifestyle — and a great-looking smile!

For more information about hard-to-see (or truly invisible) orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Orthodontics for the Older Adult” and “Clear Aligners for Teenagers.”

By Coweta Dentistry Associates
November 10, 2018
Category: Oral Health
Tags: tmj disorders  
TMDandFibromyalgiaCouldShareLinksinChronicPain

Chronic pain can turn your life upside down. While there are a number of disorders that fit in this category, two of them—fibromyalgia and temporomandibular disorders (TMD)—can disrupt your quality of life to the extreme. And it may be the two conditions have more in common than similar symptoms—according to one study, three-fourths of patients diagnosed with fibromyalgia show symptoms of TMD.

To understand why this is, let’s take a closer look at these two conditions.

Fibromyalgia presents as widespread pain, aching or stiffness in the muscles and joints. Patients may also have general fatigue, sleep problems, mood swings or memory failures. TMD is a group of conditions that often result in pain and impairment of the temporomandibular joints that join the jaw with the skull. TMD can make normal activities like chewing, speaking or even yawning painful and difficult to do.

Researchers are now focusing on what may, if anything, connect these two conditions. Fibromyalgia is now believed to be an impairment of the central nervous system within the brain rather than a problem with individual nerves. One theory holds that the body has imbalances in its neurotransmitters, which interfere with the brain’s pain processing.

Researchers have also found fibromyalgia patients with TMD have an increased sensitivity overall than those without the conditions. In the end, it may be influenced by genetics as more women than men are prone to have either of the conditions.

Treating these conditions is a matter of management. Although invasive techniques like jaw surgery for TMD are possible, the results (which are permanent) have been inconclusive in their effectiveness for relieving pain. We usually recommend patients try more conservative means first to lessen pain and difficulties, including soft foods, physical therapy, stretching exercises and muscle relaxant medication. Since stress is a major factor in both conditions, learning and practicing relaxation techniques may also be beneficial.

In similar ways, these techniques plus medication or cognitive-behavioral therapy that may influence neurotransmission can also help relieve symptoms of fibromyalgia. Be sure then that you consult with both your physician and dentist caring for both these diseases for the right approach for you to help relieve the effects of these two debilitating conditions.

If you would like more information on managing TMD or fibromyalgia, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Fibromyalgia and Temporomandibular Disorders.”

By Coweta Dentistry Associates
October 31, 2018
Category: Dental Procedures
Tags: crowns  
NotallDentalCrownsSharetheSameQualityofLife-Likeness

Dental crowns are an essential means for restoring damaged or unattractive teeth. A well-crafted crown not only functions well, it looks and blends seamlessly with the rest of the natural teeth.

Crowns are artificial caps that cover an entire visible tooth, often used for heavily decayed or damaged teeth or as added protection after a root canal treatment. Most crowns are produced by a dental lab, but some dentists are now creating them in-office with computer-based milling equipment. On the whole, the various crowns now available function adequately as teeth—but they can vary in their appearance quality.

In the early to mid 20th Century the all-metal crown was the standard; but while durable, it could be less than eye-pleasing. Although more life-like dental porcelain existed at the time, it tended to be brittle and could easily shatter under chewing stress.

Dentists then developed a crown that combined the strength of metal with the attractiveness of porcelain: the porcelain fused to metal or PFM crown. The PFM crown had a hollow, metal substructure that was cemented over the tooth. To this metal base was fused an outer shell of porcelain that gave the crown an attractive finish.

The PFM reigned as the most widely used crown until the mid 2000s. By then improved forms of porcelain reinforced with stronger materials like Lucite had made possible an all-ceramic crown. They’re now the most common crown used today, beautifully life-like yet durable without the need for a metal base.

All-ceramics may be the most common type of crown installed today, but past favorites’ metal and PFM are still available and sometimes used. So depending on the type and location of the tooth and your own expectations, there’s a right crown for you.

However, not all crowns even among all-ceramic have the same level of aesthetic quality or cost—the more life-like, the more expensive. If you have dental insurance, your plan’s benefits might be based on a utilitarian but less attractive crown. You may have to pay more out of pocket for the crown you and your dentist believe is best for you.

Whatever you choose, though, your modern dental crown will do an admirable, functional job. And it can certainly improve your natural tooth’s appearance.

If you would like more information on dental restorations, please contact us or schedule an appointment for a consultation.





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